CN117233364A - Parameter extraction method for thromboelastography - Google Patents
Parameter extraction method for thromboelastography Download PDFInfo
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Abstract
The invention provides a parameter extraction method of a thromboelastography, which comprises the following method steps: s1, keeping a measuring cup still, and collecting a first time T 1 A first amplitude curve P0' of the inner probe oscillation; s2, keeping the measuring cup still, stopping swinging of the probe, and adding a sample and a reagent into the measuring cup; s3, keeping the measuring cup still, and collecting a third time T 3 A second amplitude curve P0 of the inner probe oscillation; s4, acquiring a first viscoelastic amplitude curve P1 'and a second viscoelastic amplitude curve P2', and drawing a thromboelastography; s5, extracting absolute viscoelastic value MA of the thromboelastography from the first viscoelastic amplitude curve P1' or the second viscoelastic amplitude curve P2 1 Maximum absolute viscoelasticity MA 2 And a relative viscoelasticity value Δma. The invention effectively avoids the problem of distortion of the viscoelastic value of the thromboelastography and can be used inUnder the condition that the initial reaction of the sample is faster, the tester can conveniently judge whether the sample is a viscous sample or whether the sample starts to react.
Description
Technical Field
The invention relates to the technical field of thrombus elastography, in particular to a parameter extraction method of thrombus elastography.
Background
There are complex and sophisticated coagulation, anticoagulation and fibrinolysis systems and their fine regulatory mechanisms in the human body, and blood in blood vessels neither bleed nor coagulate to form thrombi under normal physiological conditions. However, once the above system and its regulatory mechanisms are disrupted, bleeding or thrombosis may be caused.
A Thrombi Elastography (TEG) instrument is an analyzer capable of dynamically monitoring the whole blood coagulation process, and by detecting a small amount of whole blood, the interaction between platelets, coagulation factors, fibrinogen, fibrinolysis systems and other cell components in the whole process from coagulation to fibrinolysis of a patient can be comprehensively reflected, and the Thrombi Elastography (TEG) instrument is accurate in data, simple and convenient to operate and mainly used for comprehensively detecting the whole process of coagulation and fibrinolysis and the functions of platelets. In particular, it is an international universal device for the operation to simplify the diagnosis of coagulation dysfunction, guide the blood transfusion of components, and perform liver transplantation. Blood coagulation and platelet function analyzers are increasingly used in the fields of cardiovascular surgery, liver transplantation surgery and other operations with large bleeding, paediatrics, intensive care and hemostasis research, etc., and have become an important, accurate and rapid clinical hemostasis test.
Three thromboelastometry techniques were developed around blood viscoelasticity measurements, each of which is described as follows:
(1) The Thromboelastography (TEG) principle of Haemonetics corporation of the united states is as follows: a specially prepared blood sample cup containing blood is oscillated at a certain amplitude and frequency in a temperature environment of 37 ℃. The elastic force change of the blood clot is monitored by a probe suspended by a wire and immersed in the blood sample, and the shear force generated by the rotation of the blood sample cup can be transmitted to the probe in the blood sample after the blood clot couples the blood sample cup and the probe in the blood clotting process, so that the movement amplitude of the probe is directly related to the strength of the formed blood clot. When the blood clot is retracted or dissolved, the probe's coupling to the blood clot is released and the movement of the blood sample cup is no longer transmitted to the probe. The rotation of the probe is converted into an electronic signal by the electromagnetic sensor, and a thromboelastography is generated by the data processing system after data acquisition.
(2) The principle of measurement of rotary thromboelastometer (ROTEM) from Tem, germany is as follows: the probe is immersed in the blood sample in the measuring cup, the probe and the measuring cup are coupled through blood, and the probe is driven by a spring to oscillate at an initial amplitude of 4.75 degrees and a period of 12 s. When the blood is in a liquid state without coagulation, the probe is free to move, and as the coagulation of the blood proceeds, the strength of the blood clot increases, and the force of the blood clot to prevent the probe from rotating is greater. The rotation amplitude of the probe is inversely related to the blood clot strength, the dynamic change of the probe motion is detected and recorded by an optical displacement sensor, and finally a thromboelastography and a series of detection indexes are generated by a computer.
(3) The platelet function analyzer (sonoshot) of Sienco company in the united states of america works on the principle: the disposable hollow probe connected with the ultrasonic sensor is immersed in a sample (0.4 ml of blood or plasma) to be tested in the test cup for a certain depth, and vertically oscillates at an amplitude of 1 mu m and a frequency of 200Hz, because the viscoelasticity of the sample generates a certain resistance to the free vibration of the probe, and the resistance of blood clots to the probe is gradually increased along with the progress of blood coagulation, a resistance signal is obtained by a data acquisition system, the resistance signal is displayed in a manner of a blood coagulation curve (Sonoclot signiture), and the viscoelasticity changes in the whole process of reaction coagulation.
As shown in the schematic diagram of a classical suspension wire thromboelastography machine of fig. 1, the classical suspension wire thromboelastography detection principle is as follows:
a. the sample cup is connected with the stepping motor through a transmission mechanism; the sample cover is fixedly connected with the probe, the probe is fixedly connected with the fan-shaped magnetic conduction sheet, and the probe is fixedly connected with the lower end of the thin steel wire; the upper end of the thin steel wire is fixedly connected with the frame; the coil circuit board is fixedly connected with the frame;
b. the stepping motor rotates left and right at a rotating speed of + -w 1, and the sample cup is driven to rotate left and right at a small angle through the transmission mechanism;
c. the sample cup drives the blood sample to rotate at a speed of + -w 2, the blood is solidified more and w2 is closer to w1;
d. the blood sample drives the sample cover to rotate at + -w 3, the blood is solidified more, and w3 is closer to w2;
e. the sample cover, the fan-shaped magnetic conduction sheet and the probe rotate left and right at a small angle, and the thin steel wire is twisted. When the torsion elastic force of the thin steel wire is equal to the viscous force of the blood sample, the sample cover reaches the maximum rotation angle. The angle of rotation of the sample cover is thus positively correlated with the degree of coagulation of the blood sample.
f. The coil circuit board is provided with coils, and the coils comprise an exciting coil and a feedback coil. A sine excitation signal is input into the excitation coil, and a sine feedback signal is induced in the feedback coil through magnetic conduction of the sector magnetic conduction sheet. When the relative positions of the fan-shaped magnetic conductive sheet and the coil circuit board are different, the sensed feedback signal amplitude is different. Therefore, the rotating angle of the sector magnetic conductive sheet can be judged according to the amplitude of the feedback signal. The angle is positively correlated with the extent of coagulation of the blood sample, thereby generating a thromboelastography.
Thromboelastography is the rapid measurement of the viscoelastic properties of blood as it transitions from a liquid state to a coagulated state by activating the clotting function of the blood with a clotting reagent. After the blood viscoelasticity reaches a maximum, fibrinolysis occurs, and the viscoelasticity decreases. In the suspension wire principle, the sample cup is an active rotating piece, and the sample cover of the passive piece is driven to rotate through the viscoelastic transmission of the blood sample. Therefore, the weaker the blood viscoelasticity, the smaller the probe pivot angle attached to the sample cover; the more viscoelastic the blood, the greater the probe pivot angle. The probe pivot angle is positively correlated with blood viscoelasticity.
As shown in a schematic diagram of a thromboelastography generated by a classical suspension wire thromboelastography machine in fig. 2, the abscissa in the thromboelastography represents time, the ordinate represents the amplitude value of the probe swing angle, in the generated thromboelastography, the amplitude curve of the probe swing angle is denoted as S0, the upper envelope of the amplitude curve S0 is denoted as S1, and the lower envelope of the amplitude curve S0 is denoted as S2.
The clotting reagent mixes with blood at time 0, and conventionally the intersection A of envelope S1 with the thromboelastography threshold Sthr is located on the 0-axis of the thromboelastography, i.e., the envelope S1 conventionally coincides with the thromboelastography threshold Sthr during the pre-clotting preparation time period R (the phase from time 0 to point A is the pre-clotting preparation time), and the probe is not rotated left or right or is not detected by the thin wire when the sample cup is considered to be rotated left or right.
The phase from time 0 to point a (pre-clotting preparation period R) is the pre-clotting preparation time, i.e. the phase in which the reagent activates clotting and the clotting function in the blood triggers. The classical suspension wire thromboelastography machine generates a thromboelastography, which considers the time period of blood as a conventional liquid and the intersection a of the conventional envelope S1 with the thromboelastography threshold Sthr as the point of separation of the conventional envelope S1 from the lower envelope S2.
Drawing a ray AB from the intersection point a of the envelope S1 with the threshold Sthr of the thromboelastography, which is tangent to the envelope S1 at point B, thereby extracting parameters of the thromboelastography:
(1) The slope K of the tangent line AB represents the reaction degree value of the coagulation reaction, namely the intensity degree in the process of coagulation;
(2) Conventionally the distance value MA between the maximum amplitude point C of the envelope S1 and the 0 axis of the thromboelastography represents the maximum intensity of coagulation, i.e. the viscoelasticity value;
(3) The period from the point of intersection a of the envelope S1 with the threshold Sthr of the thromboelastography, traditionally, to the point of maximum amplitude C of the envelope S1, is traditionally the phase of increasing the viscoelasticity of the blood.
(4) The maximum amplitude point C of the envelope S1 is followed by a fibrinolytic stage, the blood viscoelasticity decreases.
Classical suspension silk thrombi elastography has the following disadvantages:
the equipment is installed to be level-adjusted so as to ensure that the suspension wire is vertical and avoid the friction between the rotating part and the fixed part from affecting the test precision; the vertical dimension of the equipment is large; when the probe is combined with the sample cover, the probe is clamped by a special structure so as to avoid the stress damage of the suspension wire, and the structure of the equipment is complex. The classical thromboelastography instrument has complex operation process, manual sample addition in the test process, inaccurate liquid addition amount easily caused, various factors which interfere with experimental precision easily introduced, and a single test channel can only test one index at a time, and has low flux.
The thromboelastography generated by classical suspension wire thromboelastography machines has the following drawbacks:
the parameters of the thrombus elasticity map are limited, the maximum intensity of coagulation, namely the viscoelasticity value MA is distorted, and particularly when the initial viscoelasticity of a sample is large, the viscoelasticity value MA is distorted, so that the risk of being incapable of identifying thrombus exists. When the initial reaction of the sample is fast (it is possible that the reaction has already started at the stage of adding the sample and the reagent), since the detection is started from the intersection point a of the envelope line S1 and the threshold Sthr of the thromboelastography conventionally, it is impossible to determine whether the sample starts to react at the start of the detection.
Disclosure of Invention
The invention provides a parameter extraction method of a thromboelastography, which aims to solve the technical problems that the viscoelasticity value of the existing thromboelastography is distorted, and whether a sample starts to react or not can not be judged when detection starts.
The technical scheme provided by the invention is as follows:
an object of the present invention is to provide a parameter extraction method of thromboelastography, comprising the following method steps:
s1, keeping a measuring cup still, inserting a probe into a screw cap of the measuring cup, controlling the probe to drive the screw cap to swing in a reciprocating manner, and keeping for a first time T 1 Simultaneously collecting a first time T 1 A first amplitude profile P0' of the probe oscillation;
s2, keeping the measuring cup still, and controlling the probe to stop swinging for a second time T 2 And at a second time T 2 Adding a sample and a reagent into the measuring cup;
s3, keeping the measuring cup still, controlling the probe to drive the screw cap to swing in a reciprocating manner, and lasting for a third time T 3 Simultaneously collecting a third time T 3 A second amplitude profile P0 of the probe oscillation;
s4, drawing an upper envelope line P1 and a lower envelope line P2 according to the second amplitude curve P0; the upper envelope P1 is shifted down according to half of the maximum amplitude of the first amplitude curve P0 'to obtain a first viscoelastic amplitude curve P1',
simultaneously, the lower envelope line P2 is moved upwards according to half of the maximum amplitude of the first amplitude curve P0', a second viscoelasticity amplitude curve P2' is obtained, and a thromboelastography is drawn;
s5, extracting absolute viscoelastic value MA of thromboelastography from the first viscoelastic amplitude curve P1' or the second viscoelastic amplitude curve P2 1 Maximum absolute viscoelasticity MA 2 And a relative viscoelasticity value Δma.
In a preferred embodiment, in step S5, the first viscoelastic amplitude profile P1 'or the second viscoelastic amplitude profile P2' is extracted, at a third time T 3 Distance value of initial position from the axis of thromboelastography 0 as absolute viscoelasticity value MA of thromboelastography 1 。
In a preferred embodiment, in step S5, the maximum distance value of the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' from the axis of the thromboelastography 0 is extracted as the absolute viscoelastic maximum MA of the thromboelastography 2 。
In a preferred embodiment, in step S5, the absolute viscoelastic maximum MA of the thromboelastography is calculated 2 With absolute viscoelasticity value MA 1 By contrast, the relative viscoelasticity value Δma of the thromboelastography was calculated.
In a preferred embodiment, the parameter extraction method further includes:
s6, extracting a reaction significant increase point of the blood coagulation reaction significant increase in the thrombus elastic diagram from the first viscoelasticity amplitude curve P1 'or the second viscoelasticity amplitude curve P2'.
In a preferred embodiment, a thromboelastography threshold is provided parallel to the thromboelastography 0 axis;
when the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is at a third time T 3 Is near the thrombi-elastography 0 axis relative to the thrombi-elastography threshold;
the intersection point of the thromboelastography threshold and the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is a reaction significant increase point in the thromboelastography, in which the coagulation reaction is significantly increased;
when the first viscoelasticityThe amplitude profile P1 'or the second viscoelastic amplitude profile P2' at a third time T 3 Is remote from the thrombi-elastography 0 axis with respect to the thrombi-elastography threshold;
the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is at a third time T 3 The initial point of (2) is the point of the marked increase in the thromboelastography where the coagulation response is significantly increased.
In a preferred embodiment, the parameter extraction method further includes:
s7, extracting a reaction degree value of the coagulation reaction.
In a preferred embodiment, the degree of reaction value of the coagulation reaction is represented by the slope of a tangent line of the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' from the point of reaction significant increase.
Compared with the prior art, the technical scheme of the invention has at least the following beneficial effects:
the invention provides a parameter extraction method of a thromboelastography, which can measure an absolute viscoelastic value, an absolute viscoelastic maximum value and a relative viscoelastic value at the beginning of detection, effectively avoid the problem of distortion of the thromboelastography viscoelastic value, has more accurate measurement and has greater medical guidance significance.
The invention provides a parameter extraction method of a thromboelastography, which can be used for conveniently judging whether a sample is a viscous sample or the sample starts to react under the condition that the initial reaction of the sample is faster by extracting a reaction significant increase point of a coagulation reaction significant increase in the thromboelastography.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings required for the description of the embodiments will be briefly described below, and it is apparent that the drawings in the following description are only some embodiments of the present invention, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic diagram of a classical suspension wire thromboelastography.
Fig. 2 is a schematic representation of a thromboelastography generated by a classical suspension wire thromboelastography machine.
FIG. 3 is a schematic view of the probe of the present invention separated from the spin cap.
FIG. 4 is a schematic view of the insertion of a probe into a screw cap of the present invention.
FIG. 5 is a schematic diagram of a first amplitude profile and a second amplitude profile of probe oscillation acquired in one embodiment of the invention.
Fig. 6 is a schematic representation of a thromboelastography in one embodiment of the invention.
Fig. 7 is a schematic representation of a thromboelastography in another embodiment of the invention.
FIG. 8 is a schematic representation of a conventional thromboelastography, with smaller values of viscoelasticity measured when the initial absolute value of viscoelasticity of a sample is greater.
Fig. 9 is a schematic diagram of a thromboelastography in accordance with yet another embodiment of the present invention in comparison to a conventional thromboelastography.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention more clear, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings of the embodiments of the present invention. It will be apparent that the described embodiments are some, but not all, embodiments of the invention. All other embodiments, which can be made by a person skilled in the art without creative efforts, based on the described embodiments of the present invention fall within the protection scope of the present invention.
Unless defined otherwise, technical or scientific terms used herein should be given the ordinary meaning as understood by one of ordinary skill in the art to which this invention belongs. The terms "first," "second," and the like, as used herein, do not denote any order, quantity, or importance, but rather are used to distinguish one element from another. Likewise, the terms "a," "an," or "the" and similar terms do not denote a limitation of quantity, but rather denote the presence of at least one. The word "comprising" or "comprises", and the like, means that elements or items preceding the word are included in the element or item listed after the word and equivalents thereof, but does not exclude other elements or items. The terms "connected" or "connected," and the like, are not limited to physical or mechanical connections, but may include electrical connections, whether direct or indirect.
It should be noted that "upper", "lower", "left", "right", "front", "rear", and the like are used in the present invention only to indicate a relative positional relationship, and when the absolute position of the object to be described is changed, the relative positional relationship may be changed accordingly.
Referring to fig. 3 to 9, according to an embodiment of the present invention, there is provided a parameter extraction method for thromboelastography, including the following method steps:
step S1, keeping the measuring cup 100 still, inserting the probe 300 into the screw cap 200 of the measuring cup 100, controlling the probe 300 to drive the screw cap 200 to swing reciprocally for a first time T 1 Simultaneously collecting a first time T 1 A first amplitude curve P0' of oscillation of the inner probe 300.
The present invention obtains an amplitude profile of the oscillation of the probe 300 by rotating the probe 300 by the probe 300 while the measuring cup 100 is stationary and the probe 300 is configured to oscillate reciprocally (as shown by arrow b in fig. 4).
As shown in fig. 3 and 4, the probe 300 is separated from the spin cap 200 of the measuring cup 100 before the test. According to the invention, the screw cap 200 is arranged in the measuring cup 100, after the probe 300 is inserted into the screw cap 200 (the probe 300 is inserted into the screw cap 200 in the direction shown by the arrow a in fig. 3), after the probe 300 is inserted into the screw cap 200, the probe 300 is in interference fit with the screw cap 200, and the probe 300 drives the screw cap 200 to reciprocate together (shown by the arrow b in fig. 4).
Keeping the measuring cup 100 still, inserting the probe 300 into the screw cap 200 of the measuring cup 100, controlling the probe 300 to drive the screw cap 200 to swing reciprocally for a first time T 1 Simultaneously collecting a first time T 1 The first amplitude curve P0' of the oscillation of the inner probe 300 is the amplitude curve of the probe 300 when the probe 300 is empty, i.e. no sample is added to the measuring cup 100And the amplitude curve of the oscillation of probe 300 at reagent Y. The first amplitude curve P0' of the acquired probe 300 oscillation is shown in fig. 5. In fig. 5, the horizontal axis represents time, and the vertical axis represents the amplitude of oscillation of the probe 300.
Step S2, keeping the measuring cup 100 still, and controlling the probe 300 to stop swinging for a second time T 2 And at a second time T 2 Sample and reagent Y are added internally to the measuring cup 100.
First time T 1 After the first amplitude curve P0' of the oscillation (null-oscillation) of the inner acquisition probe 300, the probe 300 stops oscillating for a second time T 2 At a second time T 2 Sample and reagent Y are added inwardly to the gap between measuring cup 100 and screw cap 200.
Step S3, keeping the measuring cup 100 still, controlling the probe 300 to drive the screw cap 200 to swing reciprocally for a third time T 3 Simultaneously collecting a third time T 3 A second amplitude curve P0 of the oscillation of the inner probe 300.
Second time T 2 After adding the sample and the reagent Y to the gap between the measuring cup 100 and the spin-cap 200, the control probe 300 drives the spin-cap 200 to reciprocate for a third time T 3 At a third time T 3 The internal rotation cap 200 drives the sample and the reagent Y to rotate, and the third time T is collected 3 A second amplitude curve P0 of the oscillation of the inner probe 300.
At this time, the second amplitude curve P0 of the oscillation of the probe 300 is an amplitude curve of the probe 300 driving the sample and the reagent Y to rotate, i.e. an amplitude curve of the oscillation of the probe 300 when the sample and the reagent Y are added into the measuring cup 100. The second amplitude profile P0 of the acquired probe 300 oscillation is shown in fig. 5.
Step S4, drawing an upper envelope line P1 and a lower envelope line P2 according to a second amplitude curve P0; the upper envelope P1 is shifted down by half the maximum amplitude of the first amplitude curve P0', and a first viscoelastic amplitude curve P1' is obtained.
Specifically, as shown in fig. 5, an upper envelope P1 and a lower envelope P2 are plotted according to a second amplitude curve P0. The upper envelope P1 is set to the maximum amplitude 2L of the first amplitude curve P0 1 Is shifted down by half, i.e., the upper envelope P1 is shifted down by L along the longitudinal axis 1 A first viscoelastic amplitude curve P1' is obtained as shown in fig. 6.
And meanwhile, the lower envelope line P2 is moved upwards according to half of the maximum amplitude of the first amplitude curve P0', a second viscoelastic amplitude curve P2' is obtained, and a thromboelastography is drawn.
Specifically, as shown in fig. 5, an upper envelope P1 and a lower envelope P2 are plotted according to a second amplitude curve P0. The lower envelope P2 is set to the maximum amplitude 2L of the first amplitude curve P0 1 Is shifted down by half, i.e., the lower envelope P2 is shifted up by L along the longitudinal axis 1 A second viscoelastic amplitude curve P2' is obtained as shown in fig. 6.
A thromboelastography is plotted from a first viscoelastic amplitude curve P1 'and a second viscoelastic amplitude curve P2', the first viscoelastic amplitude curve P1 'being in the positive direction of the thromboelastography 0 axis and the second viscoelastic amplitude curve P2' being in the negative direction of the thromboelastography 0 axis, as shown in fig. 6.
Step S5, extracting absolute viscoelastic value MA of thromboelastography from the first viscoelastic amplitude curve P1' or the second viscoelastic amplitude curve P2 1 Maximum absolute viscoelasticity MA 2 And a relative viscoelasticity value Δma.
In the following examples, the absolute viscoelastic value MA of the thromboelastography is extracted by taking the second viscoelastic amplitude curve P2' as an example 1 Maximum absolute viscoelasticity MA 2 And a relative viscoelasticity value Δma.
It should be appreciated that the first viscoelastic amplitude curve P1' extracts the absolute viscoelastic value MA of the thromboelastography 1 Maximum absolute viscoelasticity MA 2 The manner of the relative viscoelasticity value Δma is the same as the second viscoelasticity magnitude curve P2', and will not be described again.
According to an embodiment of the invention, the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is extracted at a third time T 3 Distance value of initial position from the axis of thromboelastography 0 as absolute viscoelasticity value MA of thromboelastography 1 。
In this embodiment, the second viscoelastic amplitude curve p2'At a third time T 3 The starting position of (2) is marked as point D, the third time T 3 The starting time of (1) is denoted t0=200. Extracting the second viscoelastic amplitude curve P2' at the third time T 3 Distance value of starting position (D point) from the axis of the thromboelastography 0 as absolute viscoelastic value MA of the thromboelastography 1 。
According to an embodiment of the present invention, the maximum distance value of the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' from the axis of the thromboelastography 0 is extracted as the absolute viscoelastic maximum value MA of the thromboelastography 2 。
In this embodiment, the point of the maximum distance of the second viscoelastic amplitude curve P2' from the axis of the thromboelastography 0 is denoted as F, and the distance value of the F point from the axis of the thromboelastography 0 is extracted as the absolute viscoelastic maximum MA of the thromboelastography 2 。
According to an embodiment of the invention, the absolute viscoelastic maximum MA of the thromboelastography is calculated 2 With absolute viscoelasticity value MA 1 By contrast, the relative viscoelasticity value Δma of the thromboelastography was calculated.
In this example, the absolute viscoelastic maximum MA of the thromboelastography is used 2 With absolute viscoelasticity value MA 1 Difference, i.e. MA 2 －MA 1 The relative viscoelasticity value Δma of the thromboelastography is calculated.
As shown in FIG. 7, the present invention is applied to the initial absolute viscoelasticity value MA of a sample 1 At larger values, the absolute maximum value of viscoelasticity MA is even if the relative coagulation strength DeltaMA is not large 2 And also larger, and thus a higher risk of thrombosis is judged.
As shown in fig. 8, the conventional method only measures the viscoelastic value MA (viscoelastic value ma=relative viscoelastic value Δma), but cannot measure the absolute viscoelastic value MA 1 And absolute maximum value of viscoelasticity MA 2 I.e. the viscoelasticity value MA (corresponding to the measurement of the relative viscoelasticity value Δma alone) is measured in a conventional manner. Absolute viscoelasticity value MA at the beginning of the sample 1 With a larger value, a smaller value of the viscoelasticity MA is considered to be free of thrombus, so that the risk of thrombus in this case cannot be identified.
The invention consists of absolute viscoelasticity value MA 1 Characterization of the blood viscoelastic properties of the sample when the sample and the reagent are not reacting, absolute viscoelastic maximum MA 2 The method has the advantages that the actually measured blood viscoelasticity is characterized, the sample (blood) blood viscoelasticity is reflected more truly, and the problem that the thromboelastography only characterizes the blood pressure viscoelasticity distortion through the relative viscoelasticity value delta MA is effectively avoided.
Step S6, extracting a reaction significant increase point of the blood coagulation reaction significant increase in the thrombus elastic diagram from the first viscoelasticity amplitude curve P1 'or the second viscoelasticity amplitude curve P2'.
Specifically, according to an embodiment of the present invention, a thromboelastography threshold Sthr is set parallel to the thromboelastography 0 axis.
A thromboelastography threshold Sthr for characterizing a small increase in blood viscoelasticity before the coagulation strength begins to increase significantly, the thromboelastography threshold Sthr being preset.
As shown in fig. 6, in this embodiment, a thromboelastography threshold Sthr parallel to the thromboelastography 0 axis is set in the forward direction of the thromboelastography 0 axis. In this example, the thromboelastography threshold will be at a distance ΔSthr from the second viscoelastic amplitude curve P2' before the coagulation intensity begins to increase significantly.
When the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is at the third time T 3 Is near the thromboelastography 0 axis relative to the thromboelastography threshold Sthr;
the intersection point E of the threshold Sthr of the thromboelastography and the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is a significantly increased point of the significantly increased response of the thromboelastography, i.e. the significantly increased point of the significantly increased response of the thromboelastography is point E. The point of significant increase in response characterizes the onset of significant increase in coagulation intensity.
As shown in FIG. 6, in the present embodiment, the second viscoelastic amplitude curve P2' is at the third time T 3 Is close to the thromboelastography 0 axis with respect to the thromboelastography threshold Sthr, the intersection of the thromboelastography threshold Sthr and the second viscoelastic amplitude curve P2E is the point of significant increase in the thromboelastography where the coagulation response is significantly increased, i.e., the point of significant increase in the thromboelastography where the coagulation response is significantly increased is point E, as shown in fig. 6.
Thus, it can be judged at the third time T 3 After the start time t0=200, the sample (blood) and the reagent start to react, at a third time T 3 At the start time t0=200, the sample (blood) and the reagent have not yet started to react, i.e. at the second time T 2 During the process of adding the sample and the reagent Y, the sample (blood) and the reagent have not yet started to react.
When the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is at the third time T 3 Is far from the thromboelastography 0 axis relative to the thromboelastography threshold Sthr;
then either the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is at a third time T 3 The initial point of (2) is the point of the marked increase in the thromboelastography where the coagulation response is significantly increased.
As shown in FIG. 9, in the present embodiment, the second viscoelastic amplitude curve P2' is at the third time T 3 Is far from the thromboelastography 0 axis with respect to the thromboelastography threshold Sthr, the second viscoelastic amplitude curve P2' is at a third time T 3 The initial position point (D point) of (C) is the point of significantly increased coagulation response in the thromboelastography. The point of significant increase in the thromboelastography where the clotting response was significantly increased is point D, as shown in figure 9.
Thus, the initial absolute viscoelasticity value MA of the sample (blood) can be determined 1 Larger, or at a third time T 3 At the start time t0=200, the sample (blood) and the reagent have already started to react.
That is, it is thus possible to determine either the initial absolute viscoelasticity value MA of the sample (blood) 1 Larger; or at a second time T 2 During the process of adding the sample and the reagent Y, the sample (blood) and the reagent have already started to react.
As shown in FIG. 9, a conventional thromboelastography, at a third time T 3 Starting to rotate the sample cup at the starting time t0=200, which collects the conventional envelope S1, and only the viscoelasticity value MA (corresponding to the measurement of only the relative viscoelasticity value Δma) is measured, and the initial absolute viscoelasticity value MA of the sample (blood) cannot be determined 1 Whether or not it is large, and cannot be judged at the second time T 2 During the process of adding the sample and the reagent Y, whether the sample (blood) and the reagent start to react or not.
As shown in FIG. 9, a conventional thromboelastography, at a third time T 3 Starting to rotate the sample cup before the start time t0=200, i.e. at the second time T of addition of sample and reagent Y 2 In (before t0=200, for example at 150), the sample cup starts to rotate, which captures a further conventional envelope S1', and only a further viscoelasticity value MA' can be measured. Although the other viscoelastic value MA' is larger than the viscoelastic value MA, the initial absolute viscoelastic value MA of the sample (blood) cannot be judged as well 1 Whether or not it is large.
And S7, extracting a reaction degree value of the coagulation reaction.
From the point of significant increase in reaction (point E/point D), a tangent line of the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is drawn, and the reaction degree value of the coagulation reaction is represented by the slope of the tangent line.
As shown in fig. 6, taking the point E of the significant increase in reaction as an example, a tangent EB of the second viscoelastic amplitude curve P2 'is drawn from the point E of the significant increase in reaction, the tangent EB is B with the tangent point of the second viscoelastic amplitude curve P2', and the reaction degree value of the coagulation reaction is represented by the slope K of the tangent EB. I.e. the severity of the coagulation reaction is indicated by the slope K of the tangent EB.
Finally, the step S1 to step S7 are performed to obtain the parameter index of the thromboelastography, and the result of reporting the thromboelastography is generated from the parameter index.
The following points need to be described:
(1) The drawings of the embodiments of the present invention relate only to the structures related to the embodiments of the present invention, and other structures may refer to the general designs.
(2) In the drawings for describing embodiments of the present invention, the thickness of layers or regions is exaggerated or reduced for clarity, i.e., the drawings are not drawn to actual scale. It will be understood that when an element such as a layer, film, region or substrate is referred to as being "on" or "under" another element, it can be "directly on" or "under" the other element or intervening elements may be present.
(3) The embodiments of the invention and the features of the embodiments can be combined with each other to give new embodiments without conflict.
The present invention is not limited to the above embodiments, but the scope of the invention is defined by the claims.
Claims (8)
1. A method for extracting parameters of a thromboelastography, which is characterized by comprising the following method steps:
s1, keeping a measuring cup still, inserting a probe into a screw cap of the measuring cup, controlling the probe to drive the screw cap to swing in a reciprocating manner, and keeping for a first time T 1 Simultaneously collecting a first time T 1 A first amplitude profile P0' of the probe oscillation;
s2, keeping the measuring cup still, and controlling the probe to stop swinging for a second time T 2 And at a second time T 2 Adding a sample and a reagent into the measuring cup;
s3, keeping the measuring cup still, controlling the probe to drive the screw cap to swing in a reciprocating manner, and lasting for a third time T 3 Simultaneously collecting a third time T 3 A second amplitude profile P0 of the probe oscillation;
s4, drawing an upper envelope line P1 and a lower envelope line P2 according to the second amplitude curve P0; the upper envelope P1 is shifted down according to half of the maximum amplitude of the first amplitude curve P0 'to obtain a first viscoelastic amplitude curve P1',
simultaneously, the lower envelope line P2 is moved upwards according to half of the maximum amplitude of the first amplitude curve P0', a second viscoelasticity amplitude curve P2' is obtained, and a thromboelastography is drawn;
s5, extracting absolute viscoelastic value MA of thromboelastography from the first viscoelastic amplitude curve P1' or the second viscoelastic amplitude curve P2 1 Maximum absolute viscoelasticity MA 2 And a relative viscoelasticity value Δma.
2. The parameter extraction method according to claim 1, characterized in that in step S5, the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is extracted, at a third time T 3 Distance value of initial position from the axis of thromboelastography 0 as absolute viscoelasticity value MA of thromboelastography 1 。
3. The parameter extraction method according to claim 1, characterized in that in step S5, a maximum distance value of the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' from the thromboelastography 0 axis is extracted as an absolute viscoelastic maximum MA that is a thromboelastography 2。
4. The method according to claim 1, wherein in step S5, the absolute maximum value MA of the thromboelastography is set to 2 With absolute viscoelasticity value MA 1 By contrast, the relative viscoelasticity value Δma of the thromboelastography was calculated.
5. The parameter extraction method according to claim 1, characterized in that the parameter extraction method further comprises:
s6, extracting a reaction significant increase point of the blood coagulation reaction significant increase in the thrombus elastic diagram from the first viscoelasticity amplitude curve P1 'or the second viscoelasticity amplitude curve P2'.
6. The method of claim 5, wherein a thromboelastography threshold is set parallel to the thromboelastography 0 axis;
when the first viscoelasticityThe amplitude profile P1 'or the second viscoelastic amplitude profile P2' at a third time T 3 Is near the thrombi-elastography 0 axis relative to the thrombi-elastography threshold;
the intersection point of the thromboelastography threshold and the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is a reaction significant increase point in the thromboelastography, in which the coagulation reaction is significantly increased;
when the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is at a third time T 3 Is remote from the thrombi-elastography 0 axis with respect to the thrombi-elastography threshold;
the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is at a third time T 3 The initial point of (2) is the point of the marked increase in the thromboelastography where the coagulation response is significantly increased.
7. The parameter extraction method according to claim 5, characterized in that the parameter extraction method further comprises:
s7, extracting a reaction degree value of the coagulation reaction.
8. The method according to claim 7, wherein a tangent line of the first viscoelastic amplitude curve P1 'or the second viscoelastic amplitude curve P2' is drawn from a point of significant increase in the reaction, and the reaction degree value of the coagulation reaction is represented by a slope of the tangent line.
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